Afghan women are getting more political representation but continue to face barriers in local communities.

Kabul, Afghanistan- Just days after Afghanistan's presidential elections and 13 years after the Taliban were last in power - signs of change are evident. More than 300 women across the country campaigned for seats in the provincial council, where 20 percent of spots are reserved for women, three women served as cabinet members in President Hamid Karzai's government, and women flocked to the polls, some voting for Habiba Sarabi, the former governor of Bamyan.

Despite a relatively successful polling day, many observers believe that waging war on the Taliban has not solved many key problems facing women, despite hopes to the contrary from the country's Western backers.

"When you compare today to 2001, the gains are very big and encouraging," human rights activist Nader Nadery told Al Jazeera. "But, in Afghanistan - at best - it's mixed."

Women's rights in Afghanistan - the right to live a life free of violence, seek outside help for council or to work outside the home, are largely viewed as a "Western impositions", say most analysts.

Trust issues

"Referring to the government to achieve rights is not a decent action," Habibullah, a tribal elder from Badakshan told Al Jazeera. "It is thought of as something contrary to our culture and custom."

Silence and keeping quiet on certain issues has become a survival technique or protection mechanism.

- Nader Nadery, human rights activist

Around 80 percent of disputes across the country are still resolved using traditional methods such as shuras and jirgas according to a report by the US Institute of Peace.

"Not even 10-15 percent of those cases relating to women reach the government in remote areas," said Abdul Wahab, a prosecutor from Kunar province. "So, of course some women's rights will be violated."

Many activists oppose traditional resolution methods because they often don't include women, and many decisions are considered contrary to women's rights.

Tribal elders told Al Jazeera that jirgas may violate the rights of women some of the time. But, they say, at least the dignity of everyone involved and family relations remain intact.

Alternatively, the government justice system is largely viewed as one of the most corrupt of all Afghan institutions.

"I can't see any courts that exercise good jurisdiction," said an Afghan rights director who asked to remain anonymous. It's a statement echoed by many across the country.

Struggles for justice

Grim stories of judges presiding over forced marriage cases who offer solutions such as "marry the boy" or "marry the judge" are not unheard of and issues such as the sale of wives in eastern Ningarhar province are never spoken of, or are vehemently denied.

"Throughout the wars, the society has gone through so much change," said Nadery. "Keeping quiet on certain issues has become a survival technique or protection mechanism. There is, what I call, a 'higher degree of tolerance' towards the wrongdoings in the society, especially with issues pertaining to honour and women."

"First, people are not confident that if they raise their voice there will be a remedy to their request," he said. "They also don't have confidence that they will be protected by the institutions [if they make complaints] because there are mostly strongmen who are involved, and that makes people stay quiet."

According to a UN Assistance Mission in Afghanistan (UNAMA) report the practises are "pervasive, occurring in varying degrees in all communities, urban and rural, and among all ethnic groups".

Heather Barr of Human Rights Watch told Al Jazeera via email that women's rights and the ongoing struggle to implement the Elimination of Violence Against Women (EVAW), which practises many harmful traditional practices, is facing a critical test.

"The EVAW law is important not just for the specific protections it puts in place for women facing violence, but also for the overall message it sends to Afghan society. For too long, there has been a perception that women and girls are property, to be sold, married off, given to resolve conflicts, beaten, deployed as prostitutes, and even killed with impunity. The grand ambition of the EVAW law is to change that perception, and gradually, case by case - too slowly, but still - the EVAW law has been making a difference in how Afghan society sees women."

Activists and officials across the country said the rising number of women and family members, particularly fathers, coming forward and speaking out against injustices such as rape is encouraging for breaking taboos and moving forward.

However, some Afghan women have a different view.

"Women were told by Westerners that they have rights. Now the Westerners have left and some women here may be more aware, but, they have nothing to do with these rights and nowhere to go if they need help," said one young Afghan woman who declined to give her name.

Health barriers

Step into any state-run hospital in Afghanistan, and the barriers women face are evident.

My husband told me we could not stay because the male doctors would see me.

- Majabeen, mother

One woman who did not give her name wept on the floor of Kandahar's Mirwais hospital as doctors prepared to take her daughter-in-law for emergency surgery.

"It cost us 1000 Afghanis ($20) to get here," she told Al Jazeera. "My daughter-in-law needs surgery and we have to travel back." The car ride into Kandahar city from the district they lived took several hours on a bumpy road.

Another mother, Majabeen, from Ghazni, who like many Afghan women goes by one name only, brought her malnourished son to Kabul's Indira Gandhi Hospital for treatment.

"We stayed in a private hospital in Ghazni before coming to Kabul. It was OK," she said. "But my husband told me we could not stay because the male doctors would see me."

Cultural restrictions, the ongoing conflict, the inability to afford the high costs of healthcare, the long distances people must travel to reach healthcare facilities, and a major shortage of qualified female staff still delay or prevent Afghan women from receiving vital care.

According to Medecins Sans Frontieres (MSF), the maternal mortality ratio reportedly declined from 1,000 per 100,000 live births in 2000, to 460 per 100,000 live births in 2010, however, the country is still one of the most dangerous places in the world to give birth. During childbearing years, one in 42 women is likely to die of causes related to pregnancy and childbirth.

As the conflict continued to escalate last year, so did the the impact it had on women and children. According to UNAMA, casualties and injuries on women and children increased by 34 percent over the previous year.

The most updated records of World Health Organization (WHO), show more than 60 percent of Afghans, mostly women, suffer from psychosocial problems or mental disorders.

"War is the main contributor of many things," said Dr Saifullah Abasin, head of the malnutrition ward at Indira Gandhi Hospital. "War affects human psychology, it results in forced migration. If parents can't take care of themselves properly, how can they take good care of their children?"

In an attempt to mitigate some of the healthcare obstacles facing women, Benoit De Gryse, MSF's country representative told Al Jazeera, the group's private maternity hospital in Khost province made a deal with the community to find an all-female medical team to provide care.

"Of course that has been a bit of a challenge," said De Gryse.

At one point, MSF could not find a female anaesthesiologist. Since life-saving emergency services are performed on a daily basis, the hospital has two international anaesthesiologists at all times, but, said De Gryse, there is always the possibility that one day MSF may not be able to find international staff.

"So we had to present this idea to the community: either we hire a male anaesthesiologist, or, we will have to close the hospital. We said, 'This is your community, your culture, your rules and regulations, so it is your decision.'"

"They came back and said, 'Look, in the event of life saving for women, having a male anaesthesiologist is acceptable.'"

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